Y.I. Chazov, Minister of Health, to the CPSU CC, 'Medical Aspects of the Accident at Chernobyl AEhS'

Secret

[USSR Ministry of Health letterhead]   Copy Nº 1

CPSU CC

[CPSU CC stamp:

16 November 1987 33180]

16 November 1987 Nº 3634s

Medical Aspects of the Accident at the Chernobyl' AEhS

From the moment it received information about the accident at the Chernobyl' AEhS and considering its scale the USSR Ministry of Health took extreme measures and gave the necessary instructions to the UkSSR, BSSR, and RSFSR Ministries of Health to mobilize men and equipment/ health institutions to give medical aid to the victims, carry out first-priority medical and sanitation measures to protect the personnel of the ChAEhS and the people taking part in the liquidation of the accident, and ensure the radiation safety of the population adjacent to the rayons of the ChAEhS and the personnel taking part in the elimination of the consequences of the accident.

Additional batches of medicines were sent by special transportation to the cities of Kiev and Minsk, including preparations of stable iodine from the reserves of the USSR Ministry of Health. Teams of highly-skilled specialists, radiologists, hematologists, hygienists, physicists, and others were sent to the zone. Managers of the USSR Ministry of Health and leading scientists in the field of radiation medicine and hygiene came to the site of the accident. A Government medical commission composed of managers, senior officials of the USSR Ministry of Health, and leading scientists in the field of radiation safety began work.

The UkSSR, BSSR, and RSFSR Ministries of Health took operational measures to organize medical and sanitary aid to the population, the use of the necessary medicines and other medical and special equipment, and  dosimetric instruments of the mobilization reserve.

Medical aid to and hospitalization of the victims began 25 minutes after the accident.

Three hours after the accident iodine prophylaxis was begun for the personnel of the Chernobyl' AEhS to reduce the total exposure of the organism and the thyroid gland, and after six and a half hours, the children of the city of Pripyat'. After 12 hours the entire population of the city was covered.

Prophylactic measures were taken directed at ensuring the radiation safety of the population of the rayons adjacent to the Chernobyl' AEhS, and also a reduction of the levels of external and internal exposure in individual rayons of the UkSSR, BSSR, and RSFSR.

There were 299 people hospitalized in Moscow and 200 in Kiev in the first three days. The diagnosis of acute radiation sickness has been established in 237 people, of which 28 have died. The main part of the patients, 193 people, have gone to work unconnected to the radiation factor; sixteen people found to be invalids are not working.

A scientific prognosis of the possible consequences of the accident for the population living in the zone of increased radiation and the people taking part in the liquidation of the accident for whom a permissible radiation dose has been established has been developed with consideration for the radiation situation which has developed.

Recommendations have been issued in accordance with previously developed criteria for the adoption of a decision about the evacuation of the population living in zones of the greatest radioactive contamination. An augmented, continuous surveillance of the radiation situation has been organized in territories with an increased level of radioactive contamination, as well as radiation and health service throughout the entire territory of the country. One thousand nine hundred and sixty-four doctor and nurse teams have been enlisted in which 6932 doctors, 12195 nurses, 924 researchers from various scientific research institutes, and 504 secondary and engineering personnel have been working.

Three polyclinics, three first aid and emergency medical aid stations, an intensive care unit, 10 medical centers and eight medics' stations, and two sanitary and epidemiological stations have been created to give medical and sanitary service to the personnel of the ChAEhS and the contingents working in the 30-km zone.

Measures initiated from the first days to protect the personnel of the Chernobyl' AEhS and the people taking part in the liquidation of the accident were subsequently included in ensuring the safety of the population of the rayons adjacent to the Chernobyl' AEhS to reduce the external and internal exposure of the population of the UkSSR, BSSR, RSFSR, and other republics.

Temporary permissible levels of radioactive contamination of various surfaces (premises, transport, equipment, and other objects), also of clothing, skin surfaces, shoes, and individual means of protection; the temporary permissible levels of the content of radioactive substances in food products, drinking water, and herbs have been approved; the normative documents regulating the procedure for processing, reprocessing, and preparing and selling various products of animal husbandry, poultry farming, fur farming, feed production (together with the State Agroindustrial Committee), which have been strictly guided in their work by all organizations and institutions.

Sanitary and epidemiological services are performing the constant monitoring of the radiation situation in the territories under observation in the 30-km zone of the ChAEhS, the sale of food products, drinking water supply, including housing, various surfaces, and equipment. For example, more than 5,000,000 radiometric and dosimetric measures have been made in the eight months of 1986.

By the end of 1986 696,000 (215,000 of them children) were examined by way of medical monitoring with the use of in-depth dosimetric and laboratory methods of research.

Beginning already in June 1986 the follow-up observation of people evacuated from the 30-km zone living in the territory being observed was begun, and also of those who were taking part in the elimination of the consequences of the accident. Work is being concluded to form an All-Union Register with the goal of monitoring the state of health, the workings of the prophylactic system, and health-related measures, and also the study of the immediate and individual medical consequences.

Specialized republic prophylactic centers have been organized in the UkSSR, BSSR, and RSFSR to conduct work to give specialized medical aid, ensure the sanitary and hygienic welfare of the population, and the study of the consequences  of the accident at the Chernobyl' AEhS; a scientific research laboratory of the Leningrad Scientific Research Institute of Radiation Hygiene has been organized in Bryansk Oblast'; an additional eight inter-regional radiological units and seven radiological groups have been created; groups of individual dosimetric monitoring in the 13th SEhS [probably sanitary and epidemiological service]; additional medicines, instruments, and various equipment have been allocated, one thousand and ninety-seven appointed posts have been introduced.

As of 30 September 1987 the prophylactic observation has encompassed 620,016 people. Five thousand two hundred and thirteen people wee hospitalized with the goal of conducting an in-depth observation and confirmation of the diagnosis of the illnesses detected during prophylactic examination but unconnected with the effect of exposure.

Such a scale of work in a relative short period of time (in the year and a half since the accident) was done for the first time in world practice.

according to a proposal and recommendation developed by the USSR Ministry of Health a health improvement campaign for children was conducted, taking them to a sanatorium and health camp of resort zones. For example, in 1986 and 1987 305,500 children made use of organized rest.

The study of the state of health of the population as of November 1987 and entered into the All-Union Register did not identify illnesses which might have been blamed on a radiation factor.

Some increase of identified patients with a circulatory system illness and thyroid disease were noted when conducting an in-depth prophylactic observation. This could tie both a deeper in-depth medical examination with the involvement of specialists, as well as the influence of the psychoemotional factor, and also the endemicity in thyroid disease of the rayons of the territory under observation.

At the present time in connection with the improvement of the radiation situation associated with the decline of radionuclides and the set of measures conducted, and also a change of the nature of the work done, stricter norms have been established for the external and internal exposure of working personnel and the population living in the zones of radiation monitoring.

An All-Union Scientific Center of Radiation Medicine of three scientific research institutes has been created for an in-depth analysis of the identification of the consequences of the accident at the ChAEhS and support to the prophylactic observation of people subjected to the influence of radiation, and scientific research is being conduced according to a "Comprehensive Ecological Program of the Consequences of the Accident (the medical aspects) at the Chernobyl AEhS".

A preliminary prognosis has been developed of the possible oncological and genetic consequences for various groups and contingents of the population which on the whole ought to be considered favorable.

The forecast theoretically possible level of malignant tumors and genetic consequences for the Soviet population from the accident does not exceed the hundreds of a percent from an ordinary (spontaneous) level. The situation is also being forecast for the population of Europe in this regard. The assessments of Soviet scientists are shared by the UN Scientific Committee on the Effects of Atomic Radiation.

The organizational, preventive, and sanitary and hygienic measures taken after the accident allow the effect of radioactive substances on the population, especially Iodine-131, to be reduced as much as possible; the radiation exposure on those working to be reduced compared to the established permissible levels of radiation during the first year after exposure to be reduced; and to avert the appearance of cases of radiation illness among the population, personnel, and the contingents taking part in the liquidation of the accident, to avoid food poisoning, infectious, and other illnesses in places where large numbers of people congregate.

The radiation situation and the individual doses of radiation received by the population living in the territories under observation have turned out be within the forecast limits.

Considering the specifics of the biological effect of radiation over a long time, the medical institutions of the USSR Ministry of Health and the USSR Academy of Medical Sciences will continue a multi-year dynamic observation of the state of health of the population, monitoring of the radiation and sanitary and hygienic situation and the doses of total radiation exposure.

In March 1987 we plan to hold a national conference on the radiological consequences of the Chernobyl' accident for the Soviet population, inviting leading scientists of a number of foreign countries, including the US.

MINISTER [signature] YE. I. CHAZOV

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24 November 198[[7]]

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24 November 1987]

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